Children with Attention Deficit Hyperactivity Disorder (ADHD) show the following symptoms:

1) Poor attention span and concentration - unless totally engrossed in something (like a computer game). 2) Poor concentration and memory 3) Impulsivity - doing things without thinking first 4) Easily frustrated - often leading to temper tantrums and outbursts

While most children as well as adults face similar difficulties during daily routine, those children who suffer from ADHD have a far larger frequency of these difficulties. The extent is so acute that they are unable to undertake tasks such as:

a) at school (they are not able to pay attention or finish their work in time or they can be disruptive and destructive in class, may be talking excessively in the class )

b) at home (are not able to finish chores, are clumsy, get into fights with siblings and more)

c) socially (unable to take turns or wait in line, bossy and overbearing, easily frustrated leading to temper outbursts and aggression, impulsive, so often in trouble for doing antisocial actions e.g. unwise "practical jokes").

It would not be appropriate to include ADHD as an injuries or a disease as its onset is not dependent on a germ or any specific physical malfunction. This comes into effect only as a result of some part of the brain not working at peak efficiency and not contributing totally.

What is clear is that ADHD does run in families and is at least partially genetic - often a parent has the same symptoms. What is also clear is that the symptoms, and therefore the problems, are long term. They are not going to go away or be cured in a short period of time, but are almost certainly going to continue through into the teen years, and probably even into adulthood.

HOW IS ADHD MANAGED?

What bothers children suffering from ADHD is the danger and fear of long term implications and complications. For example:

a) Their fear of failure at school owing to poor concentration, leading to school drop out

b) they may be constantly in trouble because of their impulsivity and so be excluded from school and end up with the police,

c) they may be so discouraged by their failures that they turn to drink, drugs, crime, or become depressed and anxious.

These fears are what bother these children as these factors could influence their attitude and performance in adult life too.

Effective management of ADHD starts at home. Parents have to be very patient and give their best to their child. The treatment of ADHD is very long, but it has to be given to the child so that he is a better adjusted adult. The goal is to prevent those long term compliations. Since you as the parent know your child the best, it is you who will have to take an active part in the management of his ADHD. An effective ADHD management program should include the following components:

COMMITTED PARENTS who will work for the best for their child. There is much information, including books and videos, on ADHD and how to help your child - borrow them, buy them, read them, and become informed. But remember there is also much mis-information (especially on the internet and in newspapers and magazines), so discuss what you read with your local support group and professionals. Be especially suspicious of groups who claim to have the "magic cure" for your child.

GOOD COMMUNICATION between home, school and other professionals. This especially applies to home and school, so do all that you can to meet regularly with the school to work together on solutions for your child.

ADJUSTMENTS IN THE ENVIRONMENT. Children with ADHD do best in a quiet, calm, structured, low-stimulation environment (e.g. one to one) and poorly in chaotic situations (e.g. busy classrooms, noisy, busy homes). As a family you may want to find ways to reorganise life so that it is less stressful for all of you. At school the teachers will be doing the same, and it is best if the two can be co-ordinated.

CLEAR BEHAVIORAL MANAGEMENT STRATEGY. These children respond best to very clear expectations of behavior, and very clear rewards and punishments - with rewards being more frequent than punishments. If you are having difficulty in doing this at home you may want to talk about some strategies with your key worker.

SUPPORT FOR THE PARENTS. Looking after children with ADHD can be very stressful for the parents. Bringing up these children can be very taxing. At times it may lead to depression and marital breakdown in parents. To help the parents to cope with the stress of bringing up a ADHD child, the parents should also consult the parent support groups and parents training groups, marital counseling, and family therapy etc.

MEDICATION for ADHD should be such that reduces the symptoms and lets the child the opportunity to learn academic, social, and other life skills. The aim here should be to get the correct medicine in the right dosage. child the opportunity to learn academic, social, and other life skills.

There are several types of medication that are used. The most common are the "stimulants" (discussed on the next page), but increasingly common is the new medication atomoxetine, which seems to work very well with few side effects. Ask your doctor for full information.

As health professionals we cannot raise your child for you, nor can we solve all your problems as you travel with your child along life's journey. What we can do, however, is to assist you in getting unstuck when you get stuck along the way. We will try to help you to sort out all of the above points as best you can.

The person who has to cope with this is you and your family. Therefore, this is best addressed by you and the first step towards this is to learn as much as you can. Learning all you can results in better management and better results.